How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Facility | None | $870.96 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,023.29 | Professional | None | $812.83 | $870.96 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,318.26 | Professional | None | $707.95 | $831.76 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,412.54 | Professional | None | $758.58 | $812.83 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,047.13 Typical High $3,801.89 | Facility | None | $776.25 | $1,047.13 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,122.02 Typical High $5,370.32 | Professional | None | $467.74 | $1,122.02 | $5,370.32 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $1,071.52 | Professional | None | $426.58 | $549.54 | $1,071.52 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $102.33 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Arkansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 22nd of 51
$832
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.